The value of radiological methods in diagnosis of dysmenorrhea of puberty

The scientific article "The Value of Radiological Methods in Diagnosis of Dysmenorrhea of Puberty" presents the results of studies using non-invasive diagnostic technologies: magnetic resonance imaging and three-dimensional ultrasonography with color Doppler blood flow imaging (CDI). The evaluation of the features of radiological indices in the patients with dysmenorrhea of functional and organic genesis of severe degree based on the study of the results of 3D ultrasound examination, MRI of small pelvic organs, as well as the state of uterine and endomyometrial blood flow to improve the algorithm of diagnostics has been carried out. A high percentage (51,11%) of the rate of detection of organic pathology in the patients with severe dysmenorrhea (anomalies of the uterus development in the form of bicornuate, saddle, septal, horned, leiomyoma of the uterus body, various forms of endometriosis, combination of leiomyoma and endometriosis of womb) has been stated. Revealed hemodynamic abnormality in the basins of the uterine arteries, the low degree of arterial vascularization of subendomyometrial layer and endometrium, high vascular resistance and rate reduction in blood flow were detected, which is more evident in the patients with functional dysmenorrhea. On the basis of comparative evaluation of informativeness of the research methods, expedience of their use has been substantiated

Specific Cerebrovascular Risk Factors, Colon Microbiocenosis and its Correction in Patients Receiving Long-Term Programmed Hemodialysis

Introduction: The problem of acute and chronic cerebrovascular disorders in dialysis patients remains the most urgent. Risk factors for cerebrovascular diseases in CKD and dialysis patients can be conditionally divided into “traditional” (arterial hypertension, diabetes mellitus, hypercholesterolemia) and “specific” (associated with renal pathology and dialysis procedures). The spectrum of specific factors of cerebrovascular risk in patients with dialysis stage of the CKD includes specific dialysis factors that form during programmed HD, as well as impaired phosphorus-calcium metabolism and calcification of the arterial microvasculature, increased blood levels of β2-microglobulin, homocysteine, malondialdehyde and superoxide dismutase, a decrease in the level of nitric oxide (II) metabolites, development of nephrogenic anemia and dysfunction of blood cells, malnutrition and dietary features of patients with renal pathology, accumulation of uremic toxins and toxins of intestinal bacteria, etc. Opportunistic gut microorganisms can produce uremic toxins, which are associated with an increased risk of inflammation, increased oxidative stress, and a higher risk of cardiovascular disease (CVD). Description of the spectrum of risk factors for cerebrovascular pathology in dialysis patients and effective control over them seems to be an effective strategy aimed at increasing the duration and quality of life in patients receiving renal replacement therapy. The aim of the investigation was to study the species composition of colon microbiocenosis in patients with CKD receiving programmed HD treatment and to evaluate the effectiveness of its correction using a new immobilized synbiotic. Materials and methods: Samples of colon microbiota from 62 patients undergoing programmed hemodialysis were studied before and after a course of diet therapy that included probiotic components, in particular, the immobilized synbiotic LB-complex L. Isolation of microorganisms was carried out according to our original method; for bacteria identification, a MALDI-TOF Autoflex speed mass spectrometer (Bruker Daltonik, Germany) was used in the Biotyper program mode. The results were assessed using the criteria proposed by the authors and based on the OST 91500.11.0004-2003. The efficacy of the immobilized synbiotic was determined based on the clinical data, questionnaires, and bacteriological tests. Results: In patients receiving programmed hemodialysis (before the start of the diet therapy), chronic moderate inflammation and azotemia were found. Dysbiotic changes in microbiocenosis were revealed in all the examined patients; in the absence or suppression of lacto- and bifidoflora, the number and diversity of Bacteroides spp., Clostridium spp., Collinsella spp., Eggerthella spp. and other bacteria increased, which was consistent with the theory of functional redundancy of gut microbiota. From the answers to the questionnaires, a decrease in the quality of life was found (up to 70 points out of 100) according to six of the eight scales used. After the combined therapy using the synbiotic LB-complex L in the study group, 56% of the examined patients showed their microbiocenosis restored to normal; no grade III dysbiosis was detected in any patient. There was a significant decrease in CRP and ESR in these patients and an improvement in the quality of life by criteria reflecting physical health. Conclusion: Acute/chronic CVD in patients with CKD of the pre-dialysis and dialysis periods are the most frequent and formidable complications. The spectrum of “traditional” and “specific” CV risk factors in dialysis patients will be described in the chapter. Special attention will be paid to the intestinal microbiota and opportunistic intestinal microorganisms. The aim was to study the species composition of colon microbiocenosis in HD patients, and to evaluate the effectiveness of its correction using a new immobilized synbiotic. Materials and Methods. Samples of colon microbiota from 62 HD patients were studied before/after a course of diet therapy that included probiotic components, the immobilized synbiotic LB-complex L. MALDI-TOF Autoflex speed mass spectrometer was used in the Biotyper program mode. The efficacy of the immobilized synbiotic was determined based on the clinical data, questionnaires, and bacteriological tests. Results. Dysbiotic changes in microbiocenosis were revealed in all patients; in the absence/suppression of lacto-and bifidoflora, the number and diversity of Bacteroides spp.,Clostridium spp.,Collinsella spp.,Eggerthella spp. and other bacteria increased. After the combined therapy using the synbiotic LB-complex L in the study group, 56% of the examined patients showed their microbiocenosis restored to normal; no grade III dysbiosis was detected in any patient

The value of radiological methods in diagnosis of dysmenorrhea of puberty

The scientific article "The Value of Radiological Methods in Diagnosis of Dysmenorrhea of Puberty" presents the results of studies using non-invasive diagnostic technologies: magnetic resonance imaging and three-dimensional ultrasonography with color Doppler blood flow imaging (CDI). The evaluation of the features of radiological indices in the patients with dysmenorrhea of functional and organic genesis of severe degree based on the study of the results of 3D ultrasound examination, MRI of small pelvic organs, as well as the state of uterine and endomyometrial blood flow to improve the algorithm of diagnostics has been carried out. A high percentage (51,11%) of the rate of detection of organic pathology in the patients with severe dysmenorrhea (anomalies of the uterus development in the form of bicornuate, saddle, septal, horned, leiomyoma of the uterus body, various forms of endometriosis, combination of leiomyoma and endometriosis of womb) has been stated. Revealed hemodynamic abnormality in the basins of the uterine arteries, the low degree of arterial vascularization of subendomyometrial layer and endometrium, high vascular resistance and rate reduction in blood flow were detected, which is more evident in the patients with functional dysmenorrhea. On the basis of comparative evaluation of informativeness of the research methods, expedience of their use has been substantiated

The value of radiological methods in diagnosis of dysmenorrhea of puberty

The scientific article "The Value of Radiological Methods in Diagnosis of Dysmenorrhea of Puberty" presents the results of studies using non-invasive diagnostic technologies: magnetic resonance imaging and three-dimensional ultrasonography with color Doppler blood flow imaging (CDI). The evaluation of the features of radiological indices in the patients with dysmenorrhea of functional and organic genesis of severe degree based on the study of the results of 3D ultrasound examination, MRI of small pelvic organs, as well as the state of uterine and endomyometrial blood flow to improve the algorithm of diagnostics has been carried out. A high percentage (51,11%) of the rate of detection of organic pathology in the patients with severe dysmenorrhea (anomalies of the uterus development in the form of bicornuate, saddle, septal, horned, leiomyoma of the uterus body, various forms of endometriosis, combination of leiomyoma and endometriosis of womb) has been stated. Revealed hemodynamic abnormality in the basins of the uterine arteries, the low degree of arterial vascularization of subendomyometrial layer and endometrium, high vascular resistance and rate reduction in blood flow were detected, which is more evident in the patients with functional dysmenorrhea. On the basis of comparative evaluation of informativeness of the research methods, expedience of their use has been substantiated

The value of radiological methods in diagnosis of dysmenorrhea of puberty

The scientific article "The Value of Radiological Methods in Diagnosis of Dysmenorrhea of Puberty" presents the results of studies using non-invasive diagnostic technologies: magnetic resonance imaging and three-dimensional ultrasonography with color Doppler blood flow imaging (CDI). The evaluation of the features of radiological indices in the patients with dysmenorrhea of functional and organic genesis of severe degree based on the study of the results of 3D ultrasound examination, MRI of small pelvic organs, as well as the state of uterine and endomyometrial blood flow to improve the algorithm of diagnostics has been carried out. A high percentage (51,11%) of the rate of detection of organic pathology in the patients with severe dysmenorrhea (anomalies of the uterus development in the form of bicornuate, saddle, septal, horned, leiomyoma of the uterus body, various forms of endometriosis, combination of leiomyoma and endometriosis of womb) has been stated. Revealed hemodynamic abnormality in the basins of the uterine arteries, the low degree of arterial vascularization of subendomyometrial layer and endometrium, high vascular resistance and rate reduction in blood flow were detected, which is more evident in the patients with functional dysmenorrhea. On the basis of comparative evaluation of informativeness of the research methods, expedience of their use has been substantiated

EFFECT OF LISINOPRIL ON 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS IN PATIENTS WITH ARTERIAL HYPERTENSION AND RHEUMATOID ARTHRITIS

Aim. To study effect of 24-week treatment with lisinopril on blood pressure (BP) and arterial stiffness in patients with arterial hypertension (HT) and rheumatoid arthritis (RA).Material and methods. Twenty patients with essential HT grade  1-2 and RA (mean age 60.2±7.9 years) were treated with lisinoprilin 24 weeks in open controlled study. Office blood pressure (BP) was 147.2±9.4/87.5±8.6 mm Hg; 24-h mean  BP – 141.8±9.3/82.2±9.6 mm Hg; HT duration was 14.5±9.4 years, and RA duration – 12.3±2.6 years. A high incidence of traditional cardiovascular risk factors was identified: 95% of patients had dyslipidaemia, 45% – obesity, 35% – impaired glucose tolerance. Atherosclerosis of carotid arteries with stenosis less than 25% was diagnosed in 65% of patients. Most patients had a positive rheumatoid factor and cyclic citrullinated peptide antibodies, as well as moderate RA activity and III-IV radiologic stage of RA. All patients received methotrexate as the basic anti-inflammatory drug, 12 (60%) patients – selective cyclooxygenase-2 inhibitors, 6 (30%) patients took corticosteroids equivalent to prednisolone 7.5±5.5 mg per day. Mean  dose  of lisinopril was 12.2±9.8 mg/day. Office BP measurements, 24-hour ambulatory BP monitoring (ABPM), and  arterial stiffness evaluation were  performed initially and  at the end of the study. Arterial stiffness was assessed by cardio-ankle vascular index on the right (R-CAVI) and on the left (L-CAVI).Results. After 24-week therapy with lisinopril office systolic and diastolic BP significantly decreased by 16.0±7.2/11.6±9.1 mm Hg (p<0.0001) and 11.6±9.1 mm Hg (p<0.0001), respectively. The target BP was achieved in 16 (83%) patients. According to the ABPM 24-week therapy with lisino pril led to a significant (p<0.002) decrease in BP for all referable periods: by 12.4±9.1/7.6±3.9 mm Hg within 24 hours;  by 13.4±10.1/8.0±6.1 mm Hg for daytime; by 10.1±9.3/7.3±6.3 mm Hg for night-time. After lisinopril treatment, R-CAVI decreased from 8.9±1.7 to 8.4±1.6 relative units (p=0.011), L-CAVI decreased from 8.9±1.6 to 8.4±1.5 relative units (p=0.003).Conclusion. In patients with combination of HT and RA, 24-week therapy with lisinopril had a significant antihypertensive effect and improved the elastic properties of the vessels